Retinal vascular caliber associated with cardiac and renal target organ damage in never‐treated hypertensive patients

Daïen, Vincent; Granados, L.; Kawasaki, Ryo; Villain, Max; Ribstein, Jean; Cailar, G. Du; Mimran, A; Fesler, Pierre

doi:10.1111/micc.12344

Cited by 7 publications

(15 citation statements)

References 58 publications

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“…17 However, two of the three studies of hypertensive adult patients showed that narrower (usually considered to be better) retinal venular caliber was weakly associated with higher PWV (r = −0.06 to −0.22). 49,50 Notably, this finding was in the opposite direction to that expected. Of the four studies examining AVR, two European studies provided some evidence that lower (worse) AVRs were associated with higher PWV (in general population r = −0.18, P < 0.01 and in hypertensive patients r = −0.12, P = 0.08).…”

Section: Associations Of Retinal Microvascular Caliber With Functiocontrasting

confidence: 61%

“…In children, there was little evidence that venular caliber was associated with PWV ( r = 0.04) . However, two of the three studies of hypertensive adult patients showed that narrower (usually considered to be better) retinal venular caliber was weakly associated with higher PWV ( r = −0.06 to −0.22) . Notably, this finding was in the opposite direction to that expected.…”

Section: Resultsmentioning

confidence: 93%

“…Of the retinal vascular measures, retinal arteriolar caliber was most consistently associated with PWV in adults with cardiometabolic disorders. In these patients, narrower (worse) retinal arteriolar caliber was consistently and modestly correlated with higher (worse) PWV (correlation coefficient ( r ) range from −0.21 to −0.23, Table ) . This effect was only observed in one of three adult general population studies that compared extreme values using categorical variables .…”

Section: Resultsmentioning

confidence: 94%

“…One explanation why we did not observe an association could be that adverse changes of venules may have an adaptive response and emerge when CVD is overt 60,61. Our review included three studies performed in patients with different stages of hypertension18,49,50 ; all studies showed consistent associations between arteriolar caliber and PWV, but results were inconsistent for venular caliber. In early-stage hypertensive patients, there was little evidence to suggest that retinal venular caliber was associated with PWV,18 while in never-treated hypertensive patients there was a moderate association in the unexpected direction (eg, smaller venular caliber and worse PWV) 49,50.…”

mentioning

confidence: 86%

“…In these patients, narrower (worse) retinal arteriolar caliber was consistently and modestly correlated with higher (worse) PWV (correlation coefficient (r) range from −0.21 to −0.23, Table 2). 18,45,49,50 This effect was only observed in one of three adult general population studies that compared extreme values using categorical variables. 41 In children who were six years of age, there was little evidence of an association.…”

Section: Associations Of Retinal Microvascular Caliber With Functiomentioning

confidence: 99%

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Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

et al. 2019

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Objective Intermediate phenotypes of microcirculation (retinal microvascular caliber) are associated with cardiovascular (CV) risk factors and independently predict CV events. However, the effect of microcirculation variation on the vascular system is unclear. We conducted a systematic review and meta‐analysis of observational studies to quantify associations of retinal microvascular caliber (arteriolar, venular caliber, arteriole‐to‐venule ratio) and preclinical CV measures (large arterial function and structure). Methods We identified studies in MEDLINE, EMBASE, and PubMed (1946 to March 2018) studying (a) general population samples and (b) patients with cardiometabolic disease. Study‐specific correlation estimates were combined into meta‐analysis where possible. Results Of 1294 studies identified, 26 met inclusion criteria (general population 16, patients 10), of which five studies were included in meta‐analysis. Most studied middle‐aged adults cross‐sectionally, with one childhood study. Large arterial function and structure were predominantly assessed by pulse wave velocity and carotid intima‐media thickness, respectively. Only arteriolar caliber was consistently associated with arterial function and structure, with stronger associations observed in cardiometabolic patients. Narrower (worse) arteriolar caliber was associated with faster (poorer) pulse wave velocity (correlation coefficient (r) −0.17, 95% CI −0.25 to −0.10) and greater (poorer) intima‐media thickness (r −0.05, 95%CI −0.09 to −0.02) across all adult participants. Conclusions Retinal arteriolar, but not venular caliber, was modestly associated with large arterial function and weakly associated with large arterial structure, with stronger evidence in patients with cardiometabolic disease. This suggests that preclinical changes in large arteries and the microcirculation have some shared but mainly unique pathways to associate with cardiovascular disease.

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Section: Associations Of Retinal Microvascular Caliber With Functiocontrasting

confidence: 61%

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 94%

mentioning

confidence: 86%

Section: Associations Of Retinal Microvascular Caliber With Functiomentioning

confidence: 99%

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Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

et al. 2019

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Reproducibility of Retinal Microvascular Traits Decoded by the Singapore I Vessel Assessment Software Across the Human Age Range

Huang

Wei

Zhang

et al. 2017

American Journal of Hypertension

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BACKGROUNDRetinal microvascular traits predict adverse health outcomes. The Singapore I Vessel Assessment (SIVA) software improved automated postprocessing of retinal photographs. In addition to microvessel caliber, it generates measures of arteriolar and venular geometry. Few studies addressed the reproducibility of SIVA measurements across a wide age range.METHODSIn the current study, 2 blinded graders read images obtained by nonmydriatic retinal photography twice in 20 11-year-old children, born prematurely (n = 10) or at term (n = 10) and in 60 adults (age range, 18.9–86.1 years).RESULTSFormer preterm compared with term children had lower microvessel diameter and disorganized vessel geometry with no differences in intraobserver and interobserver variability. Among adults, microvessel caliber decreased with age and blood pressure and arteriolar geometry was inversely correlated with female sex and age. Intraobserver differences estimated by the Bland–Altman method did not reach significance for any measurement. Across measurements, median reproducibility (RM) expressed as percent of the average trait value was 8.8% in children (median intraclass correlation coefficient [ICC], 0.94) and 8.0% (0.97) in adults. Likewise, interobserver differences did not reach significance with RM (ICC) of 10.6% (0.85) in children and 10.4% (0.93) in adults. Reproducibility was best for microvessel caliber (intraobserver/interobserver RM, 4.7%/6.0%; ICC, 0.98/0.96), worst for venular geometry (17.0%/18.8%; 0.93/0.84), and intermediate for arteriolar geometry (10.9%/14.9%; 0.95/0.86).CONCLUSIONSSIVA produces repeatable measures of the retinal microvasculature in former preterm and term children and in adults, thereby proving its usability from childhood to old age.

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Central arterial stiffness and retinal vessel calibers: the Atherosclerosis Risk in Communities Study–Neurocognitive Study

Meyer

Klein

et al. 2020

Journal of Hypertension

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Retinal vascular caliber associated with cardiac and renal target organ damage in never‐treated hypertensive patients

Abstract: In never-treated HT patients, reduced CRAE and CRVE were associated with cardiac and renal preclinical damage, ie, left ventricular hypertrophy and albuminuria, but not estimated glomerular filtration rate or vascular stiffness.

Cited by 7 publications

References 58 publications

Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

Reproducibility of Retinal Microvascular Traits Decoded by the Singapore I Vessel Assessment Software Across the Human Age Range

Central arterial stiffness and retinal vessel calibers: the Atherosclerosis Risk in Communities Study–Neurocognitive Study

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